Chest radiograph classification and severity of suspected COVID-19 by different radiologist groups and attending clinicians: multi-reader, multi-case study.

OBJECTIVES: To quantify reader agreement for the British Society of Thoracic Imaging (BSTI) diagnostic and severity classification for COVID-19 on chest radiographs (CXR), in particular agreement for an indeterminate CXR that could instigate CT imaging, from single and paired images. METHODS: Twenty readers (four groups of five individuals)-consultant chest (CCR), general consultant (GCR), and specialist registrar (RSR) radiologists, and infectious diseases clinicians (IDR)-assigned BSTI categories and severity in addition to modified Covid-Radiographic Assessment of Lung Edema Score (Covid-RALES), to 305 CXRs (129 paired; 2 time points) from 176 guideline-defined COVID-19 patients. Percentage agreement with a consensus of two chest radiologists was calculated for (1) categorisation to those needing CT (indeterminate) versus those that did not (classic/probable, non-COVID-19); (2) severity; and (3) severity change on paired CXRs using the two scoring systems. RESULTS: Agreement with consensus for the indeterminate category was low across all groups (28-37%). Agreement for other BSTI categories was highest for classic/probable for the other three reader groups (66-76%) compared to GCR (49%). Agreement for normal was similar across all radiologists (54-61%) but lower for IDR (31%). Agreement for a severe CXR was lower for GCR (65%), compared to the other three reader groups (84-95%). For all groups, agreement for changes across paired CXRs was modest. CONCLUSION: Agreement for the indeterminate BSTI COVID-19 CXR category is low, and generally moderate for the other BSTI categories and for severity change, suggesting that the test, rather than readers, is limited in utility for both deciding disposition and serial monitoring. KEY POINTS: • Across different reader groups, agreement for COVID-19 diagnostic categorisation on CXR varies widely. • Agreement varies to a degree that may render CXR alone ineffective for triage, especially for indeterminate cases. • Agreement for serial CXR change is moderate, limiting utility in guiding management

The evolution of non-small cell lung cancer metastases in TRACERx

Metastatic disease is responsible for the majority of cancer-related deaths1. We report the longitudinal evolutionary analysis of 126 non-small cell lung cancer (NSCLC) tumours from 421 prospectively recruited patients in TRACERx who developed metastatic disease, compared with a control cohort of 144 non-metastatic tumours. In 25% of cases, metastases diverged early, before the last clonal sweep in the primary tumour, and early divergence was enriched for patients who were smokers at the time of initial diagnosis. Simulations suggested that early metastatic divergence more frequently occurred at smaller tumour diameters (less than 8 mm). Single-region primary tumour sampling resulted in 83% of late divergence cases being misclassified as early, highlighting the importance of extensive primary tumour sampling. Polyclonal dissemination, which was associated with extrathoracic disease recurrence, was found in 32% of cases. Primary lymph node disease contributed to metastatic relapse in less than 20% of cases, representing a hallmark of metastatic potential rather than a route to subsequent recurrences/disease progression. Metastasis-seeding subclones exhibited subclonal expansions within primary tumours, probably reflecting positive selection. Our findings highlight the importance of selection in metastatic clone evolution within untreated primary tumours, the distinction between monoclonal versus polyclonal seeding in dictating site of recurrence, the limitations of current radiological screening approaches for early diverging tumours and the need to develop strategies to target metastasis-seeding subclones before relaps

Recent neutrino oscillation results with the IceCube experiment

The IceCube South Pole Neutrino Observatory is a Cherenkov detector instrumented in a cubic kilometer of ice at the South Pole. IceCube’s primary scientific goal is the detection of TeV neutrino emissions from astrophysical sources. At the lower center of the IceCube array, there is a subdetector called DeepCore, which has a denser configuration that makes it possible to lower the energy threshold of IceCube and observe GeV-scale neutrinos, opening the window to atmospheric neutrino oscillations studies. Advances in physics sensitivity have recently been achieved by employing Convolutional Neural Networks to reconstruct neutrino interactions in the DeepCore detector. In this contribution, the recent IceCube result from the atmospheric muon neutrino disappearance analysis using the CNN-reconstructed neutrino sample are presented and compared to the existing worldwide measurements

Angular dependence of the atmospheric neutrino flux with IceCube data

IceCube Neutrino Observatory, the cubic kilometer detector embedded in ice of the geographic South Pole, is capable of detecting particles from several GeV up to PeV energies enabling precise neutrino spectrum measurement. The diffuse neutrino flux can be subdivided into three components: astrophysical, from extraterrestrial sources; conventional, from pion and kaon decays in atmospheric Cosmic Ray cascades; and the yet undetected prompt component from the decay of charmed hadrons. A particular focus of this work is to test the predicted angular dependence of the atmospheric neutrino flux using an unfolding method. Unfolding is a set of methods aimed at determining a value from related quantities in a model-independent way, eliminating the influence of several assumptions made in the process. In this work, we unfold the muon neutrino energy spectrum and employ a novel technique for rebinning the observable space to ensure sufficient event numbers within the low statistic region at the highest energies. We present the unfolded energy and zenith angle spectrum reconstructed from IceCube data and compare the result with model expectations and previous measurements

Galactic Core-Collapse Supernovae at IceCube: “Fire Drill” Data Challenges and follow-up

The next Galactic core-collapse supernova (CCSN) presents a once-in-a-lifetime opportunity to make astrophysical measurements using neutrinos, gravitational waves, and electromagnetic radiation. CCSNe local to the Milky Way are extremely rare, so it is paramount that detectors are prepared to observe the signal when it arrives. The IceCube Neutrino Observatory, a gigaton water Cherenkov detector below the South Pole, is sensitive to the burst of neutrinos released by a Galactic CCSN at a level >10σ. This burst of neutrinos precedes optical emission by hours to days, enabling neutrinos to serve as an early warning for follow-up observation. IceCube\u27s detection capabilities make it a cornerstone of the global network of neutrino detectors monitoring for Galactic CCSNe, the SuperNova Early Warning System (SNEWS 2.0). In this contribution, we describe IceCube\u27s sensitivity to Galactic CCSNe and strategies for operational readiness, including "fire drill" data challenges. We also discuss coordination with SNEWS 2.0

All-Energy Search for Solar Atmospheric Neutrinos with IceCube

The interaction of cosmic rays with the solar atmosphere generates a secondary flux of mesons that decay into photons and neutrinos – the so-called solar atmospheric flux. Although the gamma-ray component of this flux has been observed in Fermi-LAT and HAWC Observatory data, the neutrino component remains undetected. The energy distribution of those neutrinos follows a soft spectrum that extends from the GeV to the multi-TeV range, making large Cherenkov neutrino telescopes a suitable for probing this flux. In this contribution, we will discuss current progress of a search for the solar neutrino flux by the IceCube Neutrino Observatory using all available data since 2011. Compared to the previous analysis which considered only high-energy muon neutrino tracks, we will additionally consider events produced by all flavors of neutrinos down to GeV-scale energies. These new events should improve our analysis sensitivity since the flux falls quickly with energy. Determining the magnitude of the neutrino flux is essential, since it is an irreducible background to indirect solar dark matter searches

Searching for IceCube sub-TeV neutrino counterparts to sub-threshold Gravitational Wave events

Since the release of the Gravitational Wave Transient Catalogue GWTC-2.1 by the LIGO-Virgo collaboration, sub-threshold gravitational wave (GW) candidates are publicly available. They are expected to be released in real-time as well, in the upcoming O4 run. Using these GW candidates for multi-messenger studies complement the ongoing efforts to identify neutrino counterparts to GW events. This in turn, allows us to schedule electromagnetic follow-up searches more efficiently. However, the definition and criteria for sub-threshold candidates are pretty flexible. Finding a multi-messenger counterpart via archival studies for these candidates will help to set up strong bounds on the GW parameters which are useful for defining a GW signal as sub-threshold, thereby increasing their significance for scheduling follow-up searches. Here, we present the current status of this ongoing work with the IceCube Neutrino Observatory. We perform a selection of the sub-threshold GW candidates from GWTC-2.1 and conduct an archival search for sub-TeV neutrino counterparts detected by the dense infill array of the IceCube Neutrino Observatory, known as "DeepCore". For this, an Unbinned Maximum Likelihood (UML) method is used. We report the 90% C.L. sensitivities of this sub-TeV neutrino dataset for each selected sub-threshold GW candidate, considering the spatial and temporal correlation between the GW and neutrino events within a 1000 s time window